FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

27096 in Austin

Office / nonfacility

$182.38

Base rate per service

Facility setting

$74.60

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Pain management

About 27096: Image-guided sacroiliac joint injection

Reports an image-guided injection into the sacroiliac joint for diagnostic or therapeutic care when medication is delivered within the joint.

This service places a needle into the sacroiliac joint under fluoroscopic or CT guidance, typically to deliver local anesthetic, corticosteroid, or contrast. Pain medicine physicians, anesthesiologists, physiatrists, and radiologists commonly perform it in office or facility settings for suspected or established sacroiliac joint pain. The injection is intra-articular; medication placed only in nearby muscles or soft tissue is a different service.

Report the code for the guided joint injection, including the imaging guidance and arthrography when performed; do not separately report guidance for this injection. The record should identify the treated side, target joint, imaging method, needle placement, and medication or contrast delivered. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When performed with other procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

CMS billing rules for 27096

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.44 · 27%
  • Practice expense (office) RVU3.68 · 70%
  • Malpractice RVU0.14 · 3%

306.9K

Medicare services in 2024 · #306 by national volume

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

27096 compared with similar codes

Office rates for Austin, from the same CMS release.

20552

Trigger point injection

One or two muscles

$53.17

27096 is for an image-guided intra-articular SI joint injection. 20552 is for trigger-point injections into one or two muscles, not an image-guided joint injection.

64451

SI nerve block

Image-guided nerve injection

$251.92

64451 addresses nerves supplying the SI joint; 27096 delivers medication into the joint space itself.

20610

Joint injection

Major joint or bursa, no ultrasound

$70.61

20610 applies to aspiration or injection of a major joint or bursa, such as the hip or knee. 27096 specifically describes an image-guided SI joint injection.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 27096 is $164.29—$18.09 lower than the $182.38 rate in Austin. Both use the same code, release and participation basis.

27096 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $182.38

  2. Beaumont

    $164.29

    $18.09 lower than Austin

  3. Brazoria

    $173.94

    $8.44 lower than Austin

  4. Dallas

    $174.97

    $7.41 lower than Austin

  5. Fort Worth

    $173.80

    $8.58 lower than Austin

  6. Galveston

    $174.41

    $7.97 lower than Austin

  7. Houston

    $176.97

    $5.41 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 27096 ranges from $156.09 in Arkansas to $233.14 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 27096

    Office

    $168.97

    Facility

    $72.29

    $13.41 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 27096

    Office

    $198.58

    Facility

    $78.07

    $16.20 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 27096

    Office

    $200.69

    Facility

    $80.69

    $18.31 higher than Austin for the office setting.

  • Miami

    Florida · 27096

    Office

    $187.88

    Facility

    $81.83

    $5.50 higher than Austin for the office setting.

  • Chicago

    Illinois · 27096

    Office

    $182.70

    Facility

    $80.31

    $0.32 higher than Austin for the office setting.

  • Manhattan

    New York · 27096

    Office

    $201.42

    Facility

    $83.04

    $19.04 higher than Austin for the office setting.

  • Alaska*

    Alaska · 27096

    Office

    $205.63

    Facility

    $97.13

    $23.25 higher than Austin for the office setting.

  • Alabama

    Alabama · 27096

    Office

    $158.29

    Facility

    $69.16

    $24.09 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 27096

    Office

    $156.09

    Facility

    $68.58

    $26.29 lower than Austin for the office setting.

  • Arizona

    Arizona · 27096

    Office

    $171.20

    Facility

    $72.49

    $11.18 lower than Austin for the office setting.

  • Bakersfield

    California · 27096

    Office

    $186.57

    Facility

    $74.92

    $4.19 higher than Austin for the office setting.

  • Chico

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • El Centro

    California · 27096

    Office

    $186.16

    Facility

    $74.51

    $3.78 higher than Austin for the office setting.

  • Fresno

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Madera

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Merced

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Modesto

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Napa

    California · 27096

    Office

    $215.51

    Facility

    $81.24

    $33.13 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 27096

    Office

    $197.64

    Facility

    $77.23

    $15.26 higher than Austin for the office setting.

  • Redding

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Rest Of California

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 27096

    Office

    $187.67

    Facility

    $76.01

    $5.29 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 27096

    Office

    $195.29

    Facility

    $76.81

    $12.91 higher than Austin for the office setting.

  • Salinas

    California · 27096

    Office

    $194.55

    Facility

    $76.48

    $12.17 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 27096

    Office

    $199.08

    Facility

    $77.24

    $16.70 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 27096

    Office

    $228.12

    Facility

    $84.48

    $45.74 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 27096

    Office

    $227.96

    Facility

    $84.32

    $45.58 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 27096

    Office

    $233.14

    Facility

    $86.24

    $50.76 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 27096

    Office

    $232.49

    Facility

    $85.59

    $50.11 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 27096

    Office

    $191.42

    Facility

    $75.39

    $9.04 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 27096

    Office

    $200.96

    Facility

    $77.18

    $18.58 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 27096

    Office

    $195.27

    Facility

    $76.49

    $12.89 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 27096

    Office

    $202.99

    Facility

    $77.89

    $20.61 higher than Austin for the office setting.

  • Stockton

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Vallejo

    California · 27096

    Office

    $215.28

    Facility

    $81.01

    $32.90 higher than Austin for the office setting.

  • Visalia

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Yuba City

    California · 27096

    Office

    $186.14

    Facility

    $74.48

    $3.76 higher than Austin for the office setting.

  • Colorado

    Colorado · 27096

    Office

    $183.11

    Facility

    $74.72

    $0.73 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 27096

    Office

    $187.10

    Facility

    $77.38

    $4.72 higher than Austin for the office setting.

  • Delaware

    Delaware · 27096

    Office

    $173.98

    Facility

    $73.33

    $8.40 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 27096

    Office

    $181.06

    Facility

    $77.87

    $1.32 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 27096

    Office

    $172.63

    Facility

    $75.24

    $9.75 lower than Austin for the office setting.

  • Atlanta

    Georgia · 27096

    Office

    $178.74

    Facility

    $75.24

    $3.64 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 27096

    Office

    $163.31

    Facility

    $72.44

    $19.07 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 27096

    Office

    $190.56

    Facility

    $74.73

    $8.18 higher than Austin for the office setting.

  • Iowa

    Iowa · 27096

    Office

    $162.42

    Facility

    $69.21

    $19.96 lower than Austin for the office setting.

  • Idaho

    Idaho · 27096

    Office

    $163.39

    Facility

    $69.67

    $18.99 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 27096

    Office

    $170.60

    Facility

    $76.87

    $11.78 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 27096

    Office

    $167.63

    Facility

    $74.62

    $14.75 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 27096

    Office

    $182.95

    Facility

    $78.33

    $0.57 higher than Austin for the office setting.

  • Indiana

    Indiana · 27096

    Office

    $164.31

    Facility

    $69.88

    $18.07 lower than Austin for the office setting.

  • Kansas

    Kansas · 27096

    Office

    $161.57

    Facility

    $69.48

    $20.81 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 27096

    Office

    $161.65

    Facility

    $71.08

    $20.73 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 27096

    Office

    $169.07

    Facility

    $73.21

    $13.31 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 27096

    Office

    $161.36

    Facility

    $71.20

    $21.02 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 27096

    Office

    $200.99

    Facility

    $79.36

    $18.61 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 27096

    Office

    $182.02

    Facility

    $74.75

    $0.36 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 27096

    Office

    $186.54

    Facility

    $77.23

    $4.16 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 27096

    Office

    $177.26

    Facility

    $74.17

    $5.12 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 27096

    Office

    $164.09

    Facility

    $70.37

    $18.29 lower than Austin for the office setting.

  • Southern Maine

    Maine · 27096

    Office

    $172.86

    Facility

    $71.90

    $9.52 lower than Austin for the office setting.

  • Detroit

    Michigan · 27096

    Office

    $174.59

    Facility

    $76.29

    $7.79 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 27096

    Office

    $165.60

    Facility

    $72.59

    $16.78 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 27096

    Office

    $175.96

    Facility

    $71.13

    $6.42 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 27096

    Office

    $168.08

    Facility

    $72.42

    $14.30 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 27096

    Office

    $169.80

    Facility

    $72.82

    $12.58 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 27096

    Office

    $158.60

    Facility

    $70.79

    $23.78 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 27096

    Office

    $157.38

    Facility

    $69.67

    $25.00 lower than Austin for the office setting.

  • Montana**

    Montana · 27096

    Office

    $175.68

    Facility

    $73.81

    $6.70 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 27096

    Office

    $165.77

    Facility

    $70.72

    $16.61 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 27096

    Office

    $172.91

    Facility

    $71.04

    $9.47 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 27096

    Office

    $163.32

    Facility

    $69.29

    $19.06 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 27096

    Office

    $180.14

    Facility

    $74.09

    $2.24 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 27096

    Office

    $198.70

    Facility

    $80.53

    $16.32 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 27096

    Office

    $189.37

    Facility

    $78.13

    $6.99 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 27096

    Office

    $166.43

    Facility

    $73.01

    $15.95 lower than Austin for the office setting.

  • Nevada**

    Nevada · 27096

    Office

    $175.03

    Facility

    $73.06

    $7.35 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 27096

    Office

    $206.01

    Facility

    $84.88

    $23.63 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 27096

    Office

    $190.51

    Facility

    $78.96

    $8.13 higher than Austin for the office setting.

  • Queens

    New York · 27096

    Office

    $203.20

    Facility

    $82.79

    $20.82 higher than Austin for the office setting.

  • Rest Of New York

    New York · 27096

    Office

    $168.15

    Facility

    $71.38

    $14.23 lower than Austin for the office setting.

  • Ohio

    Ohio · 27096

    Office

    $165.03

    Facility

    $72.02

    $17.35 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 27096

    Office

    $161.49

    Facility

    $70.52

    $20.89 lower than Austin for the office setting.

  • Portland

    Oregon · 27096

    Office

    $188.90

    Facility

    $75.72

    $6.52 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 27096

    Office

    $173.81

    Facility

    $72.34

    $8.57 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 27096

    Office

    $182.50

    Facility

    $76.45

    $0.12 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 27096

    Office

    $165.35

    Facility

    $71.83

    $17.03 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 27096

    Office

    $176.97

    Facility

    $73.98

    $5.41 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 27096

    Office

    $180.15

    Facility

    $74.92

    $2.23 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 27096

    Office

    $165.65

    Facility

    $71.52

    $16.73 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 27096

    Office

    $172.58

    Facility

    $70.71

    $9.80 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 27096

    Office

    $162.34

    Facility

    $69.74

    $20.04 lower than Austin for the office setting.

  • Utah

    Utah · 27096

    Office

    $167.84

    Facility

    $72.08

    $14.54 lower than Austin for the office setting.

  • Virginia

    Virginia · 27096

    Office

    $172.22

    Facility

    $72.08

    $10.16 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 27096

    Office

    $176.97

    Facility

    $73.98

    $5.41 lower than Austin for the office setting.

  • Vermont

    Vermont · 27096

    Office

    $172.15

    Facility

    $71.30

    $10.23 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 27096

    Office

    $181.71

    Facility

    $74.44

    $0.67 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 27096

    Office

    $205.14

    Facility

    $80.14

    $22.76 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 27096

    Office

    $167.29

    Facility

    $69.70

    $15.09 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 27096

    Office

    $161.60

    Facility

    $73.07

    $20.78 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 27096

    Office

    $174.47

    Facility

    $72.60

    $7.91 lower than Austin for the office setting.

See how rates vary across the country

27096 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$156.09

$209.64

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$205.631
AL$158.291
AR$156.091
AZ$171.201
CA$186.14–$233.1429
CO$183.111
CT$187.101
DC$200.691
DE$173.981
FL$172.63–$187.883
GA$163.31–$178.742
GU$190.561
HI$190.561
IA$162.421
ID$163.391
IL$167.63–$182.954
IN$164.311
KS$161.571
KY$161.651
LA$161.36–$169.072
MA$182.02–$200.992
MD$177.26–$200.693
ME$164.09–$172.862
MI$165.60–$174.592
MN$175.961
MO$158.60–$169.803
MS$157.381
MT$175.681
NC$165.771
ND$172.911
NE$163.321
NH$180.141
NJ$189.37–$198.702
NM$166.431
NV$175.031
NY$168.15–$206.015
OH$165.031
OK$161.491
OR$173.81–$188.902
PA$165.35–$182.502
PR$176.971
RI$180.151
SC$165.651
SD$172.581
TN$162.341
TX$164.29–$182.388
UT$167.841
VA$172.22–$200.692
VI$176.971
VT$172.151
WA$181.71–$205.142
WI$167.291
WV$161.601
WY$174.471

Explore 27096 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 27096 in Austin, the physician’s office rate is $182.38 and the facility-setting rate is $74.60: a difference of $107.78.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 27096 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$200.62

$182.38 × 110% = $200.62

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27096 in Austin.

PPRRVU2026_Oct_nonQPP.csv

2,750

Code
27096
Physician work
1.44
Practice expense
3.68
Malpractice
0.14

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 27096 in Austin
ComponentRVULocality factorAdjusted
Physician work1.44× 1.0021.4429
Practice expense3.68× 1.0583.8934
Malpractice0.14× 0.8860.1240
Total RVUs5.4604
Conversion factor× 33.4009

Office / nonfacility rate, Austin$182.38

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 27096 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.441.002
Practice expense3.681.058
Malpractice0.140.886

(1.44 × 1.002 + 3.68 × 1.058 + 0.14 × 0.886) × $33.4009 = $182.38

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.441.002
Practice expense0.631.058
Malpractice0.140.886

(1.44 × 1.002 + 0.63 × 1.058 + 0.14 × 0.886) × $33.4009 = $74.60

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

27096 · Office / nonfacility

$182.38

Effective 2026-10-01

The base rate is $18.76 higher than on 2025-10-01, moving from $163.62 to $182.38 (11.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $163.62changed to$182.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.48 changed to 1.44
    • Practice expense RVU 3.29 changed to 3.68
    • Malpractice RVU 0.15 changed to 0.14
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $163.62

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$182.38$74.60RVU26D
2026-07-01$182.38$74.60RVU26C
2026-04-01$182.38$74.60RVU26B
2026-01-01$182.38$74.60RVU26A
2025-10-01$163.62$81.74RVU25D
2025-07-01$163.62$81.74RVU25C
2025-04-01$163.62$81.74RVU25B
2025-01-01$163.62$81.74RVU25A

27096 billing questions

When should 27096 be chosen over 20552?

Use 27096 for an image-guided injection into the sacroiliac joint itself. Code 20552 describes trigger-point injections into one or two muscles, including situations where an SI-region injection is performed without image guidance.

Can imaging guidance be billed separately?

No. Fluoroscopic or CT guidance is included in 27096, as is arthrography when performed.

How is bilateral SI joint injection reported?

Report modifier 50 when both sacroiliac joints are treated. CMS pays the bilateral procedure at 150%.

What documentation supports 27096?

Document the clinical indication, side and joint treated, imaging method and needle placement, and the medication or contrast injected. The record should support that the needle entered the joint rather than only nearby soft tissue.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery reporting are not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and the other procedure or procedures are subject to the standard 50% multiple-procedure reduction.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 27096PPRRVU2026_Oct_nonQPP.csv, line 2,750 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet